Originally Posted by CapeCodMermaid
Oh,wait....I just read back. Jesskanurse says she has psych nurse friends and a friend with a Masters in psych...hmmm...my father was a radiologist. Does that give me the knowledge I need to read CT scans???
my only hope is that jesska is confused, and that she thinks this therapeutic lying is taking place in the pts' early stages of their dementia.
btw jesska, any experienced nurse will tell you that a pt almost always experiences their grieving in the early stages.
it's in the early stages that you can apply reality orientation, and that you can tell them they have a progressive dementia.
yes, they have the right to know.
especially when their agitation and depression actually serve as masks for fear.
they know 'something's' wrong and they deserve answers.
so please keep in mind, that much of the grief work has already been done by the pt.
and to work through grief in late stage dementia?
are you serious in thinking of this as realistic?
if you had a pt w/late stage alzheimers, who is distressed and combative, what are you going to do?
first you're going to rule out pain, hunger, thirst, being wet or soiled.
if behavior still persists, frequent 1:1, quiet place, reassurance.
a nsg asst that has been looking after him, reports he misses his (dead) mother.
a nurse (w/whom the patient feels safe) will assess and try to explore.
pts' mother was supposed to come and pt is frantic, still waiting, worried sick.
now, what's the next step, since all interventions so far, have failed?
granted, the agitated pt may calm down for 30 sec, and then he'll go on his frantic search again for his mother.
are you the nurse going to look directly at your pt with warmth, concern and quietly tell him his mother is at church: and she will see him tomorrow? and perhaps you will have him follow you on your med pass for a bit, until you're satisfied that pt is feeling better?
maybe a prn if there is residual restlessness?
even if you did give a scheduled or prn med, it may take effect but it still does not mean he's not thinking about his mother.
what is the harm in putting your pts' mind at rest?
nsg in a ltc environment is unlike any type of nsg.
these residents often look at the staff as their own family.
and much of nsg has also taken a protective wing of their residents.
it is a mutually caring and trusting relationship.
you need to learn that whatever you have learned in nsg school is only a foundation.
it is your experiences in the real world that make one a true professional.
i truly hope wherever you work, you enter with an open mind.
these old nurses will teach you a thing or two.
your nsg assistants will also teach you more than you could ever hope for.
use your colleagues and your staff as invaluable resources.
keep your eyes and ears open; and sometimes, your mouth closed.
i don't know what else to tell you.
you've heard it from many experienced and competent nurses here on the bb.
and still.....
be well.
leslie
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